Empty sella syndrome and weight gain

Empty sella syndrome and weight gain

Empty Sella Syndrome (ESS) is a rare yet intriguing condition that primarily affects the sella turcica, a bony structure at the base of the brain that houses the pituitary gland. 

This article delves deep into the intricacies of Primary Empty Sella Syndrome and its hormonal implications, providing a comprehensive overview of its causes, symptoms, diagnosis, and management. 

Read on to gain insights into this unusual syndrome and understand why it’s crucial to be informed about it.

Empty sella syndrome

What is Empty Sella Syndrome (ESS)?

Empty Sella Syndrome is when the sella turcica appears empty on imaging scans, usually due to the pituitary gland being flattened. The pituitary gland is a crucial endocrine gland that produces hormones controlling other body glands. 

In many cases, ESS usually doesn’t cause serious symptoms, and many people with ESS may not experience any noticeable issues. However, it’s essential to understand the underlying cause and monitor the condition to prevent potential complications.


What’s the difference between empty sella and empty sella syndrome?

The terms "empty sella" and "empty sella syndrome" are often used interchangeably, but they can have subtle differences in meaning, particularly in a medical or clinical context.

Empty Sella:

  • Empty sella refers to a radiological finding where the sella turcica, a bony structure at the base of the brain that houses the pituitary gland, appears empty on an imaging study, such as an MRI or CT scan.
  • This appearance is usually due to the flattening or shrinkage of the pituitary gland, often filled with cerebrospinal fluid (CSF).
  • An empty sella can be a normal variant and may not cause symptoms or require any treatment, especially if the pituitary gland functions normally.

Empty Sella Syndrome (ESS):

  • On the other hand, empty sella syndrome (ESS) is a condition where the appearance of an empty sella is associated with clinical symptoms or hormonal imbalances.
  • ESS can be categorized into primary and secondary types. Primary ESS is often idiopathic and may not cause symptoms. At the same time, secondary ESS usually occurs due to an underlying condition, such as a pituitary tumor or after pituitary surgery. It may be associated with hormonal imbalances and other symptoms.
  • The management of ESS focuses on treating the underlying cause and addressing the associated symptoms, especially if there are hormonal imbalances or if the pituitary gland is not functioning properly.

How Does ESS Occur?

ESS occurs when a defect in the tissue allows cerebrospinal fluid to enter the sella turcica, causing the pituitary gland to shrink. This condition is often associated with increased intracranial pressure, possibly due to idiopathic intracranial hypertension (IIH). 

The increased pressure allows the fluid to enter the sella, leading to the appearance of an “empty sella” on imaging scans like MRI and computed tomography.

Is Primary Empty Sella Syndrome Common?

Primary Empty Sella Syndrome is relatively rare, and it is more common in middle-aged women who are overweight. The condition occurs due to a congenital disability or an underlying abnormality, and it is not usually associated with any life-threatening complications. 

However, it is crucial to monitor hormone levels and manage any hormonal imbalances that may arise.

What are the Symptoms of ESS?

Many individuals with ESS may not exhibit any noticeable symptoms. However, when symptoms occur, they’re often related to hormonal imbalances, including chronic headaches, high blood pressure, and abnormal hormone levels. 

Healthcare providers must conduct a thorough medical history and physical exam to identify abnormal hormone production and address the underlying cause.

How is ESS Diagnosed?

ESS is diagnosed through detailed images from brain imaging scans like magnetic resonance imaging (MRI) and computed tomography (CT). These imaging techniques use a strong magnetic field and radio waves to create detailed images of the brain that surrounds the pituitary gland. 

The presence of cerebrospinal fluid in the sella turcica, where the pituitary gland isn’t functioning properly, confirms the diagnosis of ESS.

Can ESS Cause Hormonal Imbalances?

Yes, ESS can lead to hormonal imbalances as it affects the pituitary gland, which controls the production of many different hormones. These imbalances can cause weight gain, abnormal hormone levels, and other endocrine-related issues. 

Managing these imbalances is crucial to prevent further complications and improve the quality of life for individuals with ESS.

Is ESS Associated with High Blood Pressure?

ESS may be associated with high blood pressure due to the hormonal imbalances it can cause. The pituitary gland plays a pivotal role in controlling hormones that regulate blood pressure, and any disruption in its function can lead to increased pressure. 

Monitoring and managing blood pressure is essential for individuals with ESS to avoid serious health complications.

How is ESS Managed and Treated?

The management and treatment of ESS focus on addressing the underlying cause and managing any associated symptoms. Hormonal therapy may be required to address imbalances and surgery may be necessary in cases where tumors are present. 

Regular monitoring and follow-up are crucial to ensure that the condition is managed effectively and that any new symptoms are addressed promptly.

Can ESS be Prevented?

There is no known way to prevent ESS, as it is often due to congenital disabilities or abnormalities. However, early detection and management can help control the symptoms and prevent complications. 

Regular check-ups and monitoring are essential, especially for individuals at a higher risk of developing this condition.

What is the Prognosis for Individuals with ESS?

The prognosis for individuals with ESS is generally good, especially when the condition is detected early and any associated symptoms are managed effectively. 

Most individuals with ESS can lead a normal life with proper management and treatment. However, continuous monitoring is essential to detect any changes in hormone levels and address any new symptoms that may arise.


  • Empty Sella Syndrome (ESS) is a rare condition where the sella turcica appears empty due to the flattening of the pituitary gland.
  • Symptoms are often related to hormonal imbalances, including high blood pressure and chronic headaches.
  • Diagnosis is primarily through imaging scans like MRI and CT, which reveal the presence of cerebrospinal fluid in the sella turcica.
  • Management involves addressing the underlying cause, managing symptoms, and regular monitoring to prevent complications.
  • Prognosis is generally good with early detection and proper management, allowing individuals with ESS to lead a normal life.

This article comprehensively overviews Empty Sella Syndrome, its implications, diagnosis, and management. Understanding this condition is crucial for early detection and effective management, preventing complications, and improving the quality of life for affected individuals.


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